How (un) healthy is the SouthCoast? And what is it costing us?

The SouthCoast region is still one of the unhealthiest in the state, but dozens of organizations, programs and grants are hoping to slowly turn the tide.

JENNIFER LADE

The SouthCoast region is still one of the unhealthiest in the state, but dozens of organizations, programs and grants are hoping to slowly turn the tide.

Plymouth and Bristol counties are the tenth and twelfth healthiest counties in the state respectively, out of fourteen, according to A County Health Rankings & Roadmaps program. A collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, the health rankings take a wide definition of health, using factors such as the rate of people dying before age 75, high school graduation rates, unemployment, limited access to healthy foods, air and water quality, income, and rates of smoking, obesity and teen births to determine the health of a region.

SouthCoast cities are less healthy than surrounding towns, according to data from the state Department of Health and Human Services. For example, the infant mortality rates from 2002 to 2005 of Brockton, Fall River and New Bedford were 7.1, 6.2 and 7 infant deaths per 1,000 live births, respectively. The infant mortality rate of the region without those three cities was 3.9 deaths per 1,000 live births.

In 2006, 26.5 percent of adults in Fall River and 25.6 percent of adults in New Bedford were obese, but the Southeast region as a whole — which includes the Cape in the Department of Health and Human Services data — had a 20.2 percent adult obesity rate, compared to 20.3 percent for the entire state.

And in 2003 to 2005, the diabetes mortality rate in Brockton, Fall River and New Bedford ranged from 23.8 to 26.3 deaths per 100,000 people. Without those three cities, the rate was 16.5, lower than the state rate of 18.4.

Dr. David Weed, executive director of Partners for a Healthier Community, noted that SouthCoast's cities are actually average performers in a state of overachievers. Massachusetts "frequently lead(s) the country" in terms of health benchmarks, so even the less healthy cities are not so unhealthy from a national standpoint.

Still, Weed acknowledged that in comparison to the cities, SouthCoast towns tend to see better health, along with higher levels of education and income and fewer stressors such as high crime.

But health issues do not all stop at town lines, as unhealthy cities can use up a lot of resources without providing as many benefits to the region and can discourage skilled, educated workers from settling there, Weed said.

"It's important that those cities really address those health concerns."

In Fall River, a concentrated effort to make the residents healthier has been in place for 10 years in the form of Healthy City Fall River, a collaboration between the city Health Department, the Mayor's office and Partners for a Healthier Community, an organization that works to improve health and quality of life for residents of Fall River, Somerset, Swansea and Westport.

Healthy City Fall River's action plan looks to address a wide array of behaviors and lifestyle issues that could fall under the heading of "health": reducing violence and tobacco use, increasing exercise and healthy eating and implementing wellness policies at schools and workplaces. Weed said it is necessary to take a holistic approach, because rarely are people unhealthy in just one way.

So Healthy City Fall River has included Fitness Challenges, summits on violence prevention, community gardens and a campaign to ban smoking in public housing, just to name a few of the dozens of projects the initiative has taken on.

Weed said the smoking rate is down from 32 to 26 percent in the past 10 years, the assault rate between youth 18 to 26 has dropped 37 percent over the last four years, and those participating in the Fitness Challenge have collectively dropped more than 20,000 pounds. Successes such as these have gained national attention, and Fall River recently won one of six inaugural Roadmaps to Health Prizes awarded by the Robert Wood Johnson Foundation for outstanding community partnerships that help people to lead healthier lives. The award came with a $25,000 grant.

"One of six in the country; we're very proud of that," Weed said of the award.

Though Fall River is an example for the region, it is not alone in taking action to improve the health of its residents.

New Bedford was one of 12 original cities involved in the Mass in Motion initiative, which primarily addresses childhood obesity in a city where 37 percent of school-aged children are overweight, according to Pauline Hamel, project coordinator for Mass in Motion New Bedford. She noted the increasing number of children with Type 2 diabetes and the statistic that says this is the first generation that has a shorter predicted lifespan than their parents.

"Think about it, how sad that is," Hamel said. Not to mention costly: Hamel said diabetes costs $10,000 per patient per year, and 86 percent of the U.S. workforce is overweight or has one chronic disease, which accounts for $153 billion dollars per year in lost productivity.

One project to try to address these health concerns is Safe Routes to Schools, which looks to get more children walking or biking to school rather than taking the bus or being driven. The initiative supports two Walk and Bike to School Days, one in May and one in October, and is working with the Massachusetts Department of Transportation to do "walk audits," which will assess current routes to school and how they can be more conducive to walking.

Nancy LaRue Bonell, a YMCA Coach and a member of Voices for a Healthier SouthCoast, another group dedicated to the region's health, said policy and environmental changes — such as banning smoking in public housing or constructing bike paths — can work wonders for people.

"We're trying to do a better job at making sure that the first choice is the healthy choice and it's the easier choice," she said.

Workplaces are another focus area for making people healthier. Southcoast Health Systems, another participant in Voices for a Healthy SouthCoast, implemented an employee wellness program that has had booming participation since it began in 2006. Smoking cessation and weight-loss programs are among the offerings, and the program was also behind a cafeteria overhaul that guides employees to more healthful options with a special icon.

"I think there's been a lot of movement on wellness," said Southcoast Wellness Coordinator Kris Aimone, citing better productivity and fewer absences from employees. "If you look nationally ... many employers are going the wellness route. There are so many positive effects from it."

Those involved in the efforts to make the region healthier see some of the tenets behind the Affordable Care Act, or "Obamacare" as it is sometimes called, as an extension of a philosophy they are already employing: Health should be maintained by individuals' lifestyles with the help of communities, not something you go to the doctor to get fixed. Weed called it "shifting the locus of care."

"Participating with a patient in understanding why they're ill, what they can do to change that ... thinking about their own lifestyle as the place where you get better," he said.

"If you put the resources into working with people much earlier in life at a time when they are healthy and teach them how to maintain that health, in time, 20 years, the cost of care will diminish."